Lori Johansen, PTA

NPI #1245789551 in De Pere, Wisconsin

Provider Information

NPI Number: 1245789551
Entity Type: Individual
Name: Lori Johansen, PTA
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapy Assistant
Credential: PTA
Enumeration Date: Sep 27, 2016
Last Updated: Sep 27, 2016

Practice Location

Address: 200 S 9TH ST
City: De Pere
State: Wisconsin
ZIP Code: 54115-1393
Phone: (920) 336-5680

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapy Assistant	225200000X	Primary

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